Guide to Pre-Existing Disease Cover In Health Insurance

The advantages of having health insurance are numerous. Health insurance has a number of advantages, but it also comes with limitations, such as pre-existing condition coverage.

Many individuals believe that pre-existing conditions are not covered by health insurance. However, this is not true at all. For these conditions, you may be eligible for an insurance reimbursement under pre-existing disease health insurance.

The process of obtaining health insurance for someone with a pre-existing condition was not simple (PED). The previous PED clause contained a number of terms and conditions that prohibited people with pre-existing diseases from using their health insurance. The pre-existing disease list and pre-existing disease health insurance coverage, however, have been updated by the Insurance Regulatory and Development Authority of India (IRDAI). #

Pre-existing diseases are specifically covered by each health insurance plan in India. It’s crucial to understand a few specifics about how insurance companies handle these conditions and what you need to know about pre-existing condition health insurance before you purchase health insurance for your family.

Health Insurance

What Is Pre-Existing Conditions Health Insurance?

The new definition has now established itself as a game-changer. The Insurance Regulatory and Development Authority of India (IRDAI) defined a pre-existing illness as a medical condition, ailment, disease, or injury that the insured individual had before purchasing a medical insurance plan in accordance with a circular issued by IRDAI on February 10, 2020. Any such medical problem that was identified by a doctor 48 months before the policy’s issue or reinstatement date is regarded as a pre-existing condition. #

Only conditions that are common and were identified before the purchase of insurance are now regarded as PEDs. As a result, if you had a condition before the insurance took effect but were ignorant of it or it had not yet been identified, PED would not cover it. *

When purchasing a health insurance policy for conditions that already exist, keep the following in mind:

1. Pre-existing condition health insurance terms and conditions might vary

Depending on the health insurance policy, kind of coverage, riders, insurance firm, etc., the pre-screening procedure, waiting period, list of pre-existing conditions, etc., may vary. Most insurance companies will ask you to get a medical exam.

2. You must always report any existing medical conditions.

Hiding facts or giving the insurance company false information will simply make matters more difficult for you. Insurance companies maintain the right to deny your claim and terminate your policy if pre-existing diseases are not disclosed.

3. Pre-existing diseases are not always covered by health insurance

Pre-existing conditions are not always covered by health insurance coverage. You might not receive any protection from certain illnesses under some plans. You must check with the insurance provider at the time of purchase and make an informed choice of plan.

4. There is a waiting period for conditions that already exist.

The fundamental idea behind the waiting period is that you cannot use health insurance right away after purchasing a coverage. The policyholder must wait for a predetermined period of time, which can be anything from 30 days to 4 years.

5. The cost of your health insurance policy may increase due to a pre-existing condition.

A pre-existing condition may affect your medical insurance plan’s premium. In comparison to applicants without medical conditions, you would have to pay a higher premium if you had a pre-existing condition. By withholding information now, you can save more money in the long run, but if your claim is denied and you are left paying high medical expenses out of pocket. ##

* Standard T&C Apply

** Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.

# Visit the official website of IRDAI for further details.

## All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.